RCP 111 Quiz 2

A 21-year-old woman in the emergency room is displaying rapid and deep, labored breathing. Her room ABG reveals a pH of 7.25, PaCO2 of 28, HCO3- of 14 mEq/L, and a base excess of -14 mEq/L. How would the respiratory therapist assess her acid-base condition? 1. Severe hyperventilation 2. Partially compensated metabolic acidosis 3. Compensatory response to the metabolic acidosis 4. Severe hypoventilation Select one: a. 1, 2, and 3 only b. 1 and 3 only c. 3 only d. 2, 3, and 4 only

a. 1, 2, and 3 only

Causes of respiratory acidosis in patients with normal lungs include which of the following? 1. Neuromuscular disorders 2. Spinal cord trauma 3. Anesthesia 4. Use of incentive spirometry Select one: a. 1, 2, and 3 only b. 4 only c. 2, 3, and 4 only d. 1 and 3 only

a. 1, 2, and 3 only

A metabolic acidosis caused by HCO3- loss: 1. can be a result of ammonium chloride ingestion. 2. will cause an increased anion gap. 3. may be referred to as hyperchloremic acidosis. 4. accompanied by Cl- gain. Select one: a. 1, 3, and 4 only b. 1 and 3 only c. 3 only d. 2, 3, and 4 only

a. 1, 3, and 4 only

An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3- of 18 mEq/L. What compensatory measure has the body taken to at least partially compensate for the acid-base disorder? Select one: a. Blown off CO2 b. Retained HCO3- c. Retained H+ d. Not enough information to determine

a. Blown off CO2

If the blood PCO2 is high, the kidneys will do which of the following? Select one: a. Excrete more H+ and reabsorb more HCO3-. b. Excrete less H+ and reabsorb more HCO3-. c. Excrete less H+ and reabsorb less HCO3-. d. Excrete more H+ and reabsorb less HCO3-.

a. Excrete more H+ and reabsorb more HCO3-.

An ABG result shows pH of 7.35, PaCO2 of 30 mm Hg, and HCO3- of 18 mEq/L. Which of the following is the patient's most likely primary disorder? Select one: a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

a. Metabolic acidosis

In a patient with Kussmaul's respirations, what acid-base disturbance would you expect to see? Select one: a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

a. Metabolic acidosis

Approximately how much CO2 is removed daily by the lungs? Select one: a. ~24,000 mmol/L of CO2 b. ~14,000 mmol/L of CO2 c. ~34,000 mmol/L of CO2 d. ~4,000 mmol/L of CO2

a. ~24,000 mmol/L of CO2

According to the Henderson-Hasselbalch equation, the pH of the blood will be normal as long as the ratio of HCO3- to dissolved CO2 is which of the following? Select one: a. 10:1 b. 20:1 c. 24:1 d. 30:1

b. 20:1

Based on the following ABG results, what is the most likely acid-base diagnosis? pH = 7.28, PCO2 = 53 mm Hg, HCO3- = 25.8 mEq/L Select one: a. Acute metabolic acidosis b. Acute respiratory acidosis c. Partially compensated metabolic acidosis d. Partially compensated respiratory acidosis

b. Acute respiratory acidosis

A patient has a pH of 7.49. How would you describe this? Select one: a. Acidemia b. Alkalemia c. Not sufficient information to determine d. Normal acid-base status

b. Alkalemia

How is acute respiratory acidosis accomplished? Select one: a. By increasing HCO3- reabsorption b. By increasing alveolar ventilation c. By decreasing HCO3- reabsorption d. By decreasing alveolar ventilation

b. By increasing alveolar ventilation

Compensation for metabolic acidosis occurs through which of the following? Select one: a. Increase in blood CO2 levels b. Decrease in blood CO2 levels c. Decrease in blood HCO3- levels d. Increase in blood HCO3- levels

b. Decrease in blood CO2 levels

A patient with a measured plasma HCO3- concentration of 24 mmol/L has an episode of acute hypoventilation, with the PCO2 rising from 40 to 70 mm Hg. What do you predict will happen acutely to the plasma HCO3- concentration? Select one: a. HCO3- will remain unchanged. b. HCO3- will rise to approximately 27 to 28 mmol/L. c. HCO3- will fall to approximately 20 to 21 mmol/L. d. HCO3- will rise to approximately 54 to 55 mmol/L.

b. HCO3- will rise to approximately 27 to 28 mmol/L.

Compensation for respiratory alkalosis occurs through which of the following? Select one: a. Renal excretion of H+ b. Renal excretion of HCO3- c. Renal excretion of NH4+ d. Renal reabsorption of HCO3-

b. Renal excretion of HCO3-

According to the Henderson-Hasselbalch equation, the blood pH will rise (alkalemia) under which of the following conditions? 1. The buffer capacity increases. 2. The volatile acid (CO2) increases. 3. The volatile acid (CO2) decreases. 4. The buffer capacity decreases. Select one: a. 1 only b. 3 only c. 1 and 3 only d. 2 and 4 only

c. 1 and 3 only

A patient has a bicarbonate concentration of 36 mEq and a PCO2 of 60 mm Hg. What is the approximate pH? Select one: a. 7.2 b. 7.3 c. 7.4 d. 7.5

c. 7.4

The primary goal of acid-base homeostasis is to maintain which of the following? Select one: a. Normal HCO3- b. Normal PCO2 c. Normal pH d. Normal PO2

c. Normal pH

Fixed acids are produced primarily from the catabolism of which of the following? Select one: a. Carbohydrates b. Fats c. Proteins d. Simple sugars

c. Proteins

An increase in the H+ ion concentration [H+] of the blood due only to an increase in the arterial PCO2 (hypercapnia) best describes which of the following? Select one: a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

c. Respiratory acidosis

Metabolic acidosis may be caused by: 1. an increase in fixed (nonvolatile) acids. 2. an increase in blood carbon dioxide (CO2). 3. excessive loss of bicarbonate (HCO3-). Select one: a. 1 only b. 1 and 2 only c. 1, 2, and 3 d. 1 and 3 only

d. 1 and 3 only

A patient has a blood gas result of: pH 7.29, PaCO2 of 60 mm Hg, and a HCO3 of 18 mEq/L. What is the blood gas indicating? 1. It is indicating a combined acidosis. 2. Patient has a primary respiratory and a primary metabolic disorder. 3. Compensation is not possible. Select one: a. 3 only b. 1 and 2 only c. 2 and 3 only d. 1, 2, and 3

d. 1, 2, and 3

Compensation for respiratory acidosis occurs through which of the following? Select one: a. Decrease in blood CO2 levels b. Decrease in blood HCO3- levels c. Increase in blood CO2 levels d. Increase in blood HCO3- levels

d. Increase in blood HCO3- levels

A decrease in the H+ ion concentration [H+] of the blood caused by a low PaCO2 best describes which of the following? Select one: a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

d. Respiratory alkalosis

An ABG result shows the pH to be 7.56 and the HCO3- to be 23 mEq/L. Which of the following is the most likely disorder? Select one: a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

d. Respiratory alkalosis